麦冬类中药组织切片计算机三维重建图鉴

利用计算机技术实现麦冬类中药组织连续切片三维重建与动态显示,为计算机辅助生药学鉴定和教学提供了新的三维图像技术和研究资料。     

Long-term survivorship analysis of cruciate-sparing versus cruciate-sacrificing knee prostheses using meniscal bearings

A comprehensive, interchangeable, low-contact-stress, mobile-bearing knee prosthesis system was developed and used over a 12-year period with both cemented and cementless fixation. Individual components of the system included a bicruciate-retaining meniscal bearing, a posterior cruciate-retaining meniscal bearing, and a cruciate-sacrificing, rotating-platform tibial component mated to the same femoral and rotating patellar components. Survivorship analysis of each implant type was performed to identify specific failure modes and trends for long-term survival of the implants in a wide variety of primary knee arthroplasties. Clinically, there were 46 prostheses of the bicruciate type followed for up to 12 years, 57 prostheses of the posterior-cruciate type followed for up to six years, and 108 prostheses of the rotating-platform type followed for up to ten years. All knees in this study had rotating-bearing patellar prostheses. Cumulative survivorship analysis using an end point of implant revision or a poor knee score revealed a small early failure rate of each implant in the first three years, associated with technical positioning or undersizing errors. This study indicates a predictable long-term survival of both cruciate-retaining and cruciate-sacrificing mobile-bearing knee prostheses as well as rotating-bearing patellar prostheses when used in primary knee arthroplasties that minimized technical errors of insertion.     

Dizziness and the autonomic dysfunction syndrome

Dizziness resulting from inner ear or CNS disease has been well described. However, there is a large number of patients for whom dizziness does not seem to be related to either the ears or the CNS. We postulate an abnormality in the autonomic nervous system of such patients and have used standard tilt testing and Valsalva methods to assess the abnormality. Based on the results of these tests, we can suggest therapeutic options.     

Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting

The study presented here was performed in order to create a rule that identifies subjects at high risk for invasive candidiasis in the intensive care setting. Retrospective review and statistical modelling were carried out on 2,890 patients who stayed at least 4 days in nine hospitals in the USA and Brazil; the overall incidence of invasive candidiasis in this group was 3% (88 cases). The best performing rule was as follows: Any systemic antibiotic (days 1–3) OR presence of a central venous catheter (days 1–3) AND at least TWO of the following—total parenteral nutrition (days 1–3), any dialysis (days 1–3), any major surgery (days −7–0), pancreatitis (days −7–0), any use of steroids (days −7–3), or use of other immunosuppressive agents (days −7–0). The rate of invasive candidiasis among patients meeting the rule was 9.9%, capturing 34% of cases in the units, with the following performance: relative risk 4.36, sensitivity 0.34, specificity 0.90, positive predictive value 0.01, and negative predictive value 0.97. The rule may identify patients at high risk of invasive candidiasis. Results of this project were partially presented at Focus on Fungal Infections 14, New Orleans, LA, USA, 2004. Abstract no. 51.     

Gastro-oesophageal reflux disease: Medical or surgical treatment? Report of an interactive workshop

Gastroesophageal reflux disease (GERD) is the most common disease of the upper gastrointestinal tract. With the introduction of proton pump inhibitors medical treatment of GERD has been significantly improved. However, the development of laparoscopic antireflux surgery resulted in an increasing interest of surgeons in this disease. An interactive meeting was organized in order to develop an agreement between gastoenterologists and surgeons regarding therapeutic decisions and this is the main topic of this paper.     

Enterovesical fistula secondary to mucinous adenocarcinoma of appendix

We report an unusual case of an enterovesical fistula secondary to adenocarcinoma of the appendix.     

The effect of somatostatin on experimental intestinal obstruction.

The effect of somatostatin (SS-14) was tested in an anesthetized rabbit model of closed-loop ileal obstruction. Experimental groups included (1) immediate treatment (N = 6) receiving SS-14 2,000 pmol X kg-1 X h-1 intravenously (I.V.) beginning at the time of ileal obstruction, (2) delayed treatment (N = 5) receiving SS-14 beginning 6 hours following ileal obstruction, and (3) control (N = 6) receiving only hydration. After 24 hours, all rabbits were killed. Significantly decreased intestinal luminal volume and sodium and potassium output was observed with both immediate and delayed SS-14 treatment when compared to control. Additionally, the gross and microscopic pathologic features of intestinal distension, inflammation, and necrosis seen in control rabbits were absent in rabbits treated with SS-14. The known broad spectrum of physiologic activity of SS-14 on the gastrointestinal tract appeared beneficial in this rabbit model of intestinal obstruction.